It is all too common that I hear from patients their experiences with food sensitivity or allergy testing. This has inspired this post, and I will begin with explaining some of the nuances of immunological reactions to food, pets, or plants. In a biological stance, the reactions of sensitivity and allergy are distinct. Include food intolerances in that and you have a myriad of things to consider when trying to demystify adverse food reactions. While intolerances are straight forward, like that of lactose intolerance when you lack the enzyme lactase responsible for its breakdown, allergy and sensitivity are more nuanced. By definition, the difference between the two are rooted in the antibodies, or immunoglobulins, that your body produces in response to a molecular pattern. Sensitivity, such as hypersensitivity to poison ivy, is characterized by both the class of antibody it produces and how it presents. While allergy can resemble something as extreme as anaphylaxis which can be life threatening, hypersensitivity reactions to poison ivy produce a vesicular rash that is spread through breaking the vesicle when scratching. In real world cases, these clear delineations do not stand up. Frequently we see a different class of antibody show up in the literature when describing Celiac disease, or gluten sensitivity. Also, food reactions can have instant and delayed responses like that of the dermatological reactions observed clinically. Personally, my reactions take an allergic and sensitivity presentation when I experience what would be considered allergies, itchy and watery eyes, sneezing, and runny nose, followed by a dermatological one with eczema or seborrheic dermatitis presenting after a day or two has passed. These reactions could be explained by various immunological responses found in textbooks and literature but are now wholly described under current scientific understanding. This leads me to testing, while I have heard of all sorts of versions of food intolerance/sensitivity/allergy, I have not found one to be scientifically sound. This is not to say that these tests have no merit, and while their conclusions are questionable, I have heard of patients who have benefited. Skin prick tests, for example, do not resemble the way in which we interact with food or even allergens. Cats might inject a little bit of themselves when they scratch you, but that does not explain how one who is allergic to cats might react when simply entering a home with them. Food is not introduced to the body via subdermal injection, and with a healthy gastrointestinal system, they are fully broken down and selectively absorbed through predictable mechanisms. The more advanced testing includes searching the blood for those antibodies specific to certain molecules like gluten and gliadin, but there lies an issue though when these are put to the test. My university conducted a study in which the same blood samples were sent to multiple laboratories and repeated. The conclusion was that none of these results came back consistent.
Ultimately, the interest comes down to treatment, and while allergists will suggest shots of tiny doses of the allergens found with testing, a form of conventional homeopathy, the naturopathic approach is quite different. While the identification of food sensitivities is important in establishing a healthy GI tract, the foods that you might be reacting to could actually be a result of poor microbial health as well as a damaged intestinal lining, that when repaired would allow for food tolerance. This is in contrast though, to those highly inflammatory foods which would damage anyone. Deep fried foods and those high in saturated fats might lead to systemic inflammatory responses that are unavoidable due to the nature of oxidative stress they impart onto you with their consumption. My recommendation to patients usually involves eating a highly simplified diet, which allows for the identification of highly reactive foods. An elimination diet of sorts, instead of removing everything and reintroducing foods slowly, the dietary changes I usually suggest involves eating freely but keeping track of the ingredients and reducing their numbers to make it easier to identify those that are problematic. The hardest challenge is that some of those reactions are delayed and therefore looking back twenty-four to forty-eight hours might be required. This is also why food journaling can be so powerful in recollection. While most people experience allergies symptoms, blame the pollen, and consume anti-histamines, my approach is to recall what was eaten. Though there are other culprits out there such as air pollutants, namely artificial fragrances, and even simply just a large exposure to particulates, with those ruled out you can bet it is related to diet.